Restless sleep predicts widespread pain in older adults

By Lucy Piper, Senior medwireNews Reporter

Non-restorative sleep appears to be a key factor associated with the likelihood of older adults developing widespread pain, study findings reveal.

“In this study non-restorative sleep was the strongest predictor of new onset widespread pain,” report lead researcher John McBeth (Keele University, UK) and colleagues.

They also note that they previously found that restorative sleep predicted the resolution of symptoms in patients with widespread pain.

“Together these data suggest that sleep may offer a modifiable target to improve outcome in this patient group,” the researchers write. “The clinical effectiveness of pharmacological and non-pharmacological approaches to sleep should be tested in randomized controlled trials.”

The researchers surveyed 4326 people aged a median of 63 years, 1562 of whom reported no pain at enrolment and 2764 some pain.

Three years later, 800 (18.5%) patients reported new-onset widespread pain, using blank body mannequins, while 3526 (81.5%) were free of widespread pain.

A total of 24.6% of those reporting some pain at baseline developed new-onset pain, compared with 7.7% of those who were free of pain at baseline.

Multivariate analysis including sociodemographical, psychological and clinical factors showed a number of independent factors associated with onset of widespread pain.

The strongest of these was experiencing non-restorative sleep on most nights, at an odds ratio (OR) of 1.9, followed by pain at baseline (OR=1.1), definite anxiety on the Hospital Anxiety and Depression scale (OR=1.5), poor physical health-related quality of life on the Short Form Health Survey-12 items (OR=1.3) and cognitive complaint on the Alertness Behavior Subscale of the Sickness Impact Profile (OR=1.3).

Increasing age was associated with a decreased likelihood of new-onset widespread pain, at an OR of 0.97.

Even when the effects of osteoarthritis, a common source of pain in older adults, were taken into consideration, the association of non-restorative sleep, cognitive impairment, anxiety and physical health with widespread pain onset remained significant.

“This study suggests that in addition to [osteoarthritis], sleep, cognitive impairment, anxiety and physical health may be important treatment targets,” the team concludes in Arthritis and Rheumatism.

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